# Medical education in Hong Kong

Modern medical education in Hong Kong started in 1887 with the founding of the Hong Kong College of Medicine for Chinese. Currently, two universities provide MBBS degree for doctors and six universities provide undergraduate degrees in other subjects of health sciences.

## History

The Hong Kong College of Medicine for Chinese (Chinese: 香港華人西醫書院) was founded in 1887 by the London Missionary Society, with its first graduate (in 1892) being Sun Yat-sen. Sun following the 1911 Xinhai Revolution, which changed China from an empire to a republic, became president of China. The Hong Kong College of Medicine for Chinese was the forerunner of the School of Medicine of the University of Hong Kong, which started in 1911.

## Medical and healthcare education institutes

| Institute | Organisation | Undergraduate programmes provided |
| University of Hong Kong | Li Ka Shing Faculty of Medicine | M.B., B.S. (Bachelor of Medicine & Bachelor of Surgery) Bachelor of Nursing Bachelor of Pharmacy Bachelor of Chinese medicine Bachelor of Biomedical Science |
| University of Hong Kong | Faculty of Dentistry | Bachelor of Dental Surgery |
| University of Hong Kong | Faculty of Education | Bachelor of Science in Speech-Language Pathology |
| The Chinese University of Hong Kong | Faculty of Medicine | M.B., Ch.B. (Bachelor of Medicine & Bachelor of Surgery) Bachelor of Nursing Bachelor of Pharmacy Bachelor of Science in Public Health Bachelor of Chinese medicine Bachelor of Science in Gerontology Bachelor of Science in Community Health Practice |
| Hong Kong Polytechnic University | Faculty of Health and Social Sciences | Bachelor of Science in Physiotherapy Bachelor of Science in Occupational therapy Bachelor of Science in Nursing Bachelor of Science in Mental Health Nursing Bachelor of Science in Medical laboratory Science Bachelor of Science in Radiography Bachelor of Science in Optometry Bachelor of Science in Applied Ageing Studies Bachelor of Science in Veterinary Nursing |
| Hong Kong Polytechnic University | School of Professional Education and Executive Development | Bachelor of Science Scheme in Applied Sciences (with specialism in Health Studies) |
| Hong Kong Metropolitan University | School of Nursing and Health Studies | Bachelor of Nursing with Honours in General Health Care Bachelor of Nursing with Honours in Mental Health Care |
| Hong Kong Baptist University | School of Chinese Medicine | Bachelor of Pharmacy in Chinese Medicine Bachelor of Chinese Medicine and Bachelor of Biomedical Science |
| Tung Wah College | Department of Nursing and Health Sciences | Bachelor of Health Science Major in Nursing Bachelor of Health Science Major in Applied Gerontology |
| Tung Wah College | Department of Rehabilitation and Social Sciences | Bachelor of Science in Occupational Therapy |
| Tung Wah College | Department of Medical Science | Bachelor of Medical Science Major in Basic Medical Sciences Bachelor of Medical Science Major in Forensic Science Bachelor of Medical Science Major in Medical Laboratory Science Bachelor of Medical Science Major in Radiation Therapy Bachelor of Medical Science Major in Veterinary Health Studies |
| Caritas Institute of Higher Education | School of Health Sciences | Bachelor of Nursing (Honours) Programme Bachelor of Science (Honours) in Physiotherapy |
The intakes of various healthcare related Bachelor's programmes in Hong Kong are limited.
Hong Kong has only two comprehensive medical faculties, the Li Ka Shing Faculty of Medicine, University of Hong Kong and the Faculty of Medicine, Chinese University of Hong Kong, and they are also the sole two institutes offering pharmacy and six-year medical programmes. Both universities' medical programmes are composed of two parts, two to three years of pre-clinical studies (duration depends on whether the student is a high school graduate or a degree holder pursuing for another degree), and three years of clinical years. Throughout the three years of clinical clerkship, students are rotated in general medicine, surgery, and other specialties. In order to better address Hong Kong's healthcare needs, there have been calls for the creation of a third medical school in Hong Kong.
Other healthcare discipline programmes are dispersed among other universities which do not host a medical faculty.
Various postgraduate courses in different fields of healthcare or biomedical sciences are also provided by those institutes.
In addition to Bachelor program, some education bodies, public hospitals and private hospitals were acknowledged as registered nurse/ enrolled nurse training schools by The Nursing Council of Hong Kong to provide higher diploma programmes or professional diploma programmes, in order to increase manpower of Enrolled Nurses and Registered Nurses in the industry.
| Institute | Organisation | Programmes ProvidedThis section may require cleanup to meet Wikipedia's quality standards. The specific problem is: Many empty boxes. Please help improve this section if you can. (March 2024) (Learn how and when to remove this message) |
| Queen Mary Hospital | | |
| Queen Elizabeth Hospital | School of Nursing | Higher Diploma in Nursing |
| Princess Margaret Hospital | | |
| Prince of Wales Hospital | | |
| Caritas Medical Centre | School of Nursing | Higher Diploma in Nursing |
| Kwong Wah Hospital | | |
| United Christian Hospital | | |
| Hong Kong Sanatorium and Hospital | School of Nursing | Higher Diploma in Nursing (Enrolled Nurses-General) (HD-EN) Programme |
| Tuen Mun Hospital | School of General Nursing | |
| Yan Chai Hospital | | |
| HKU School of Professional and Continuing Education, the University of Hong Kong | The College of Life Sciences and Technology | |
| HKU SPACE Community College, the University of Hong Kong | | Higher Diploma in General Nursing (Enrolled Nurses) |
| St. Teresa’s Hospital | School of Nursing | Higher Diploma in General Nursing (Enrolled Nurse) Programme Professional Diploma in Nursing |
| Union Hospital | School of Nursing | Higher Diploma in General Nursing (Enrolled Nurses) |
| Pamela Youde Nethersole Eastern Hospital | | |
| Hongkong Adventist Hospital and Tsuen Wan Adventist Hospital | Hongkong Adventist School of Nursing | |
| Hong Kong Baptist Hospital | The School of Nursing | Higher Diploma Nursing Program |
| The Grantham Hospital | | |
| Haven of Hope Hospital | | |
| Tung Wah Eastern Hospital | | |
| Our Lady of Maryknoll Hospital | | |
| Kowloon Hospital | | |

## Internship

To be registered as medical practitioners, medical graduates must successfully undertake and complete at least one year of supervised practice, generally known as an internship, with satisfactory performance. The internship is undertaken in hospital positions accredited for this purpose.
During this year interns (house officers) are rotated to four specialties (medicine and surgery plus two of obstetrics and gynaecology, paediatrics, orthopaedics and traumatology, emergency medicine, psychiatry or ophthalmology). Each of them lasts three months. There is no work hour limit in Hong Kong and interns are expected to work 80–100 hours per week.

## Non-local medical graduates

Prior to the 1997 Handover of Hong Kong, medical degrees from HKU and CUHK were eligible for full registration with the General Medical Council in the UK. However, reciprocality for UK or Commonwealth medical graduates has since been abolished. In order to become a fully registered medical practitioner in Hong Kong, all non-local medial graduates are required to attain a medical license (LMCHK) from the Medical Council of Hong Kong. The rigorous process includes passing a 3-part licentiate examination (HKMLE). In 2017, the Licentiate Society, an independent, non-profit entity, formed to represent the LMCHK and to help meet their professional needs. Medical graduates from HKU and CUHK are exempted from taking the HKMLE.

## Residency

After successful completion of medical school, graduates are awarded a provisional registration for their internship year (i.e. the first year of residency). Internship is guaranteed for HKU and CUHK medical graduates and for non-local graduates that have passed the Licentiate Examination. Upon successful completion of the intern year (PGY1), medical graduates are awarded a full registration, and can practice as general practitioners in either the public or private sector. Many, however, choose to pursue specialist training within the Hospital Authority, and enter into a four to six year program, after which they will have attained a specialist registration. Unlike those in the UK or North America, numerous residency programs in Hong Kong remain unfilled after the annual match process, with up to fifty unfilled training posts every year.

## Specialist training

Specialist training is only offered at hospitals under the Hospital Authority of Hong Kong. A trainee has to undergo one year of pre-registration internship and four to six years of supervised specialist training and pass in the exit examination or assessment held by Hong Kong Academy of Medicine, which is a statutory body tasked to organise, monitor, assess and accredit all medical and dental specialist trainings in Hong Kong to uphold high professional standard of medical / dental specialists.
Passing the exit examination or assessment is a prerequisite to Fellowship of the Academy. The examinations are all conjoint with the British and Australian royal colleges, e.g. Royal College of Physicians, Australian and New Zealand College of Anaesthetists. For example, a Hong Kong trained general surgeon in Hong Kong will be eligible for FCSHK, FHKAM (General Surgery), FRCS (General Surgery) and FRCS (Edinburgh) while a radiologist will expect to obtain FHKCR, FHKAM (Radiology) and FRCR at the end of their fellowship training. The FHKAM examination focuses on local pathology and also incorporates other components, e.g. logbook evaluation, literature appraisal, teaching, research and annual viva voce that are not included by the Royal College examinations. The pass rate of the FHKAM is similar to that of the Royal College exams, at around 20-60% depending on specialty.
Under the Hong Kong Academy of Medicine, there are 15 colleges offering 73 specialties:
| Colleges | Speciality | Years of training |
| The Hong Kong College of Anaesthesiologists | Anaesthesiology | 6 years |
| The Hong Kong College of Anaesthesiologists | Intensive Care Medicine | 6 years |
| The Hong Kong College of Anaesthesiologists | Pain Medicine | 6 years |
| Hong Kong College of Community Medicine | Community Medicine | |
| Hong Kong College of Community Medicine | Administrative Medicine | 6 years |
| Hong Kong College of Community Medicine | Public Health Medicine | 6 years |
| Hong Kong College of Community Medicine | Occupational and Environmental Medicine | 6 years |
| The College of Dental Surgeons of Hong Kong | Community Dentistry | 6+ years |
| The College of Dental Surgeons of Hong Kong | Endodontics | 6+ years |
| The College of Dental Surgeons of Hong Kong | Family Dentistry | 6+ years |
| The College of Dental Surgeons of Hong Kong | Oral & Maxillofacial Surgery | 6+ years |
| The College of Dental Surgeons of Hong Kong | Orthodontics | 6+ years |
| The College of Dental Surgeons of Hong Kong | Paediatric Dentistry | 6+ years |
| The College of Dental Surgeons of Hong Kong | Periodontology | 6+ years |
| The College of Dental Surgeons of Hong Kong | Prosthodontics | 6+ years |
| Hong Kong College of Emergency Medicine | Clinical Toxicology | |
| Hong Kong College of Emergency Medicine | Emergency Medicine | 6 years |
| The Hong Kong College of Family Physicians | Family Medicine | 6 years |
| The Hong Kong College of Obstetricians and Gynaecologists | Obstetrics and Gynaecology | 6 years |
| The Hong Kong College of Obstetricians and Gynaecologists | Gynaecological Oncology | |
| The Hong Kong College of Obstetricians and Gynaecologists | Maternal and Fetal Medicine | |
| The Hong Kong College of Obstetricians and Gynaecologists | Reproductive Medicine | |
| The Hong Kong College of Obstetricians and Gynaecologists | Urogynaecology | |
| The College of Ophthalmologists of Hong Kong | Ophthalmology | 6 years |
| The Hong Kong College of Orthopaedic Surgeons | Orthopaedics and Traumatology | 6 years |
| The Hong Kong College of Orthopaedic Surgeons | Rehabilitation | |
| The Hong Kong College of Otorhinolaryngologists | Otorhinolaryngology | 6 years |
| Hong Kong College of Paediatricians | Paediatrics | 6 years |
| Hong Kong College of Paediatricians | Developmental–Behavioural Paediatrics | |
| Hong Kong College of Paediatricians | Genetics and Genomics (Paediatrics) | |
| Hong Kong College of Paediatricians | Paediatric Endocrinology | |
| Hong Kong College of Paediatricians | Paediatric Immunology, Allergy and Infectious Diseases | |
| Hong Kong College of Paediatricians | Paediatric Neurology | |
| Hong Kong College of Paediatricians | Paediatric Respiratory Medicine | |
| Hong Kong College of Paediatricians | Paediatric Haematology and Oncology | |
| The Hong Kong College of Pathologists | Pathology | 6 years |
| Hong Kong College of Physicians | Anatomical Pathology | |
| Hong Kong College of Physicians | Chemical Pathology | |
| Hong Kong College of Physicians | Forensic Pathology | |
| Hong Kong College of Physicians | Genetic and Genomic Pathology | |
| Hong Kong College of Physicians | Haematology | |
| Hong Kong College of Physicians | Immunology | |
| Hong Kong College of Physicians | Clinical Microbiology and Infection | |
| Hong Kong College of Physicians | Cardiology | |
| Hong Kong College of Physicians | Clinical Pharmacology and Therapeutics | |
| Hong Kong College of Physicians | Critical Care Medicine | |
| Hong Kong College of Physicians | Dermatology and Venereology | |
| Hong Kong College of Physicians | Endocrinology, Diabetes, and Metabolism | |
| Hong Kong College of Physicians | Gastroenterology and Hepatology | |
| Hong Kong College of Physicians | Genetics and Genomics (Medicine) | |
| Hong Kong College of Physicians | Geriatric Medicine | |
| Hong Kong College of Physicians | Haematology and Haematological Oncology | |
| Hong Kong College of Physicians | Immunology and Allergy | |
| Hong Kong College of Physicians | Infectious Disease | |
| Hong Kong College of Physicians | Internal Medicine | |
| Hong Kong College of Physicians | Medical Oncology | |
| Hong Kong College of Physicians | Nephrology | |
| Hong Kong College of Physicians | Neurology | |
| Hong Kong College of Physicians | Palliative Medicine | |
| Hong Kong College of Physicians | Respiratory Medicine | |
| Hong Kong College of Physicians | Rheumatology | |
| The Hong Kong College of Psychiatrists | Psychiatry | 6 years |
| Hong Kong College of Radiologists | Radiology | 6 years |
| Hong Kong College of Radiologists | Interventional Radiology | |
| Hong Kong College of Radiologists | Clinical Oncology | 6 years |
| Hong Kong College of Radiologists | Nuclear Medicine | 6 years |
| The College of Surgeons of Hong Kong | Cardio-thoracic Surgery | |
| The College of Surgeons of Hong Kong | General Surgery | |
| The College of Surgeons of Hong Kong | Neurosurgery | |
| The College of Surgeons of Hong Kong | Paediatric Surgery | |
| The College of Surgeons of Hong Kong | Plastic Surgery | |
| The College of Surgeons of Hong Kong | Urology | |
| The College of Surgeons of Hong Kong | Vascular Surgery | |
Promotion to a further post, e.g. Associate Consultant, often depends on availability of posts: it is primarily dependent on whether a senior consultant has left for private practice, leaving a vacancy. The salary cap, at the resident level (i.e. Medical Officer), is currently limited to $152,356 HKD per month (at 2016/17 levels). This is exclusive of a 5% housing allowance, and up to 15% gratuity annually, to be released every three years. This has generated an exodus of specialists from the HA to the private sector, and the HA has responded by pledging to promote all specialists to Associate Consultants within 5 years of obtaining specialist qualification. However, this is not a permanent policy and is subject to the government budget. Before the new policy, it was not unusual to see public doctors remaining as 'Medical Officers' more than 10 years after obtaining their specialist qualifications. (1)
Family medicine is recognized as a major specialty in Hong Kong. Specialists in family medicine have undertaken at least six years of accredited training, and earned internationally renowned postgraduate medical qualifications as well as Fellowship of The Hong Kong Academy of Medicine just as their counterparts in hospital medicine or other medical fields.

## Continuing medical education
### Specialists

A registered practitioner who wishes to have his/her name included in the Specialist Register of the Medical Council of Hong Kong is required to satisfy the continuing medical education (CME) requirements as stipulated by the Medical Registration Ordinance (Cap 161).
The objective of the CME is to
* maintain, develop or increase the knowledge, skills and competencies relevant to the practice of specialists that may change over the years;
* enhance professional performance to enable the delivery of quality professional care and safe standard of practice to the patients, and public that specialists serve, and;
* ensure that specialists will remain competent throughout their professional career.
The Hong Kong Academy of Medicine requires each specialist to attain a minimum CME requirement of 90 points in a 3-year cycle. A point is equivalent to 1 hour of participation in CME activities. To encourage active learning elements and a balanced mix of different activities, the Academy limits the passive CME points (i.e. points obtained through attending lectures or talks) to 75 points maximum per cycle. Each college of the Academy may recommend additional requirements.

### Non-specialists

The Medical Council of Hong Kong has also implemented a CME programme for practising doctors who are not taking CME for specialists. Enrolment to the programme is on a voluntary basis. The purpose of the programme is to encourage practising doctors to keep themselves up-to-date on current developments in medical practice so as to maintain a high professional standard.
Practising doctors who have accumulated the required minimum credit points per year, i.e. 30 credit points, will be awarded a certificate to certify that they have achieved a satisfactory level of CME activity during a particular period. Such a certificate can be displayed inside the doctor's office. In addition, those practising doctors who have accumulated the required minimum credit points during a three-year cycle, i.e. 90 credit points, will be allowed to use the title "CME certified" on their visiting cards.

## Graduate entry medicine

The two medical schools in Hong Kong do not offer such programs and postgraduates have to undergo the same programme as high school graduates. Despite that, postgraduates are increasing in number in local medical schools, now amounting to one fourth of the entire student population. However, graduate entry students may be permitted to enter into the second year of medical school based on their previous major.

## Career structure in the Hospital Authority

| Rank | HA General Pay Scale Point |
| Intern | 16 |
| Resident | 30-44B |
| Resident Specialist | 30-44B |
| Associate Consultant | 45-49 |
| Consultant | 50-53A |